HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 3 LT 10 Municipality of Anchorage Page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~I,U'~OO~"! PID Number: Ot~'_? q/
R,c~,zr~/ ~ ~ ~11 Wastewater System: ~ New ~ Upgrade
Address:
P.~.~o~z~ow~ ~ ~ ~z~ ABSORPTION FIELD
Phone: ~'Z~/Z IN°'°fB~drO°ms: ~ Deep Trench ~ShallowTrench ~Bed ~Mound ~Other
LEGAL DESCRIPTION r ~. ~ Soi,...n,: ~'~ GPD/Sq. Ft. Total Depth fromj~,original7 ~grade:
Lot: Block: Subdiv~ion:~ Depth to pipe bo~om from original grade: Gravel depth beneath pipe
I0 3 ~11; ~ ~ ~' Et ~.~ ~t.
Township: ~ Range: J Section: Fill added above original grade: Gravel length:
I
WELL: D New ~ Upgrade Gravel width: Number of lines: l Distan~ betweealines:
~.~' Ft. ] -- Ft.
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~.
Driller: Date Drilled: StaticWater Level: installer: ~ Date installed:
SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P.
To Septic Absorption Lift Holding Public/Pdvat( Manufacturer: Capacityin gallons:
From Tank F[erd Station Tank Sewer Lines ~ C~ ~e T~ I
Material: Number of Com~a~ments:
w~r- - .... ~/
Sudace
w~t~, ~ ~, > ~, - LIFT STATION
LineL°t ~5-' ~ - . Size in gallons:~ Manufacturer:
I
Found tio - I
Cu~ainDrain -- . - . Pump Make & Model Electrical Inspections pe~ormed by:
Remarks: ~11 ~" ~u~ ~ ua/ut BENCH MARK
I~/~, D~ h~ ~ '~ LocationandDescription:
~ I ~ ~ Io~ /1~ ~o~0 ~. ~o~ ~. ] Assumed Elevation:
Inspectlonspedormedby. Floh~ Te~4 ~ ~ Dates. lst ~/ ~/)W¢ ~/ /
Department of Heal~ and Huma~Se~ices approval .... ,~ :~:~,,~,~-~
7
Rev ewed and approved by: Date ~- ""~. ~,~,~,,~
72-013 (Rev. 9/91) MOA 25
PERMIT NO: SW980061
PID NO: 01534123
,, LOT 10
,' BLOCK 3
/ BDRM HOUSE
/ NEW
~ 1250 GALLON
T.H. SEPTIC TANK
A
#2 DBL. C.O:~
EII
DIVERTER
VALVE
PAGE 2 OF 3
NEW 72' LONG SOIL ABS. TRENCH
W, 6.0' SEWER GVL BELOW PIPE
SEPTIC SYSTEM
(THIS AREA)
SWING TIES:
LOT9
FROM: COR."A" COR."B" COR."C"
TO:
S.T.C.O. "D" 34' 13' 34.5'
S.T.C.O. "E" 39.5' 21' 37.5'
DBL. C.O. "F" 42' 24.5' 39.5'
DIV. VALVE "G" 43' 41.5'
TR. C.O. "H" 58' 38.5'
TR. M.T. "1" 88' 73' 76'
TR. C.O. "J" 112' 84'
PRE-EXISTING
SEEPAGE PIT
CONFIG.)
LOT 10, BLOCK 3, VALLI VUE EST. UNIT #2
SEPTIC SYSTEM UPGRADE
AS-BUILT PLAN VIEW
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
SCALE: 1": 30'
DRAWN BY TFM
JULY, 1998
PERMIT NO: SW980061 PAGE 3 OF 3
PID NO: 01534123
ELEV. 99.0
,~v. j ~.o ~o~ ,~v. ~ io~ ~
6.0 SEWER ~AVEL BELOW
: :
fik~VA/lO~ 87.3'
. OF A ~
%b.t".......'"~O~'
LOT 10, BLOGK 3, VALLI VUE EST. UNIT ~2
8EPTIG SYSTEM UPG~DE
AS-~UILT PROFILE
FLA~OP TEC~IC~ SER~CES NOT TO SCALE
14530 ECHO ST~ET DRAWN BY TFM
~CHO~OE, A~S~ 99516 JULY, 1998
Rick Mystrom,
Mayor
Mmaici p ali y of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
' http://www.ci.anchorage.ak.us
August 7, 1998
Ted Moore, P.E.
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
Subject: Waiver Request for Lot 10 Block 3 Valli Vue Estates #2
Waiver Request #WR980045, :PID #015-341-23, SW980061
Dear Mr. Moore:
Your request for a waiver of the required 10 foot separation
between an on-site wastewater disposal system and a lot line has
been approved. The waived distance is from the leachfield to the
south property line common with Lot 9 of 5 feet.
This approval applies to the existing on-site wastewater disposal
system lot line separation only. Any future upgrade to the on-site
wastewater disposal system will require all separations be met or
another approval from this department.
If there any further questions or concerns regarding this waiver,
please call our office at 343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
ljw #7
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR#II%Qqg~%%~ PID# 015-341-23 HA%
Date Received: July 14, 1998
Legal Description: Lot 10 Block 3 Valli Vue Estates #2
Engineer: Ted Moore~ P.E., Flattop Technical Services
14530 Echo Street, Anchorage, Alaska 99516
Applicant: Richard & Sharon Randall
Permit ~ SW980061
Waiver Requested: Lot line waiver of leachfield to be 5' from south property
line common with Lot 9
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: ~
List Conditions or Reasons for
Waiver is NOT Granted:
above: ~£~ ~//~/~ ~ ~/~qED
Name of Reviewer
Rec #i 03780/3052 Amount: $ 115.00 Date Paid: July 14, 1998
0,00 ~o~,,z~
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW980061
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES
OWNER NAME:RANDALL RICHARD C & SHARON R
OWNER ADDRESS:PO BOX 230444
ANCHORAGE, AK 99523
DATE ISSUED: 4/13/98
EXPIRATION DATE: 4/13/99
PARCEL ID:01534123
LEGAL DESCRIPTION:
VALLI VUE ESTATES #2 BLK
3 LT 10
LOT SIZE: 22603 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS {18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THIS PERMIT IS TO REPLACE A COLLAPSED SEPTIC TANK
RECEIVED BY: ~'--~ ~
ISSUED BY:
DATE:
DATE:
THEODORE F. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345-1355 ANCHORAGE, ALASKA 99516
May 11, 1998
M.O.A. DHHS
P.O. Box 19-6650
Auchorage, AK 99519
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of a requested
amendment to Permit # SW980061 issued on 4/13/98 to replace a collapsing septic tank serving the 4
bedroom residence on Lot 10, Block 3, Vaili Vue S/D #2, located at 6462 Lone Tree Circle. When the
waste line from the new septic tank was being tied into the existing seepage pit, it became evident that
the seepage pit had experienced times in the past when it had been filled above the level of the top of the
crib. Thus, we wish to amend the existing permit to construct a new soil absorption trench along with a
diverter valve allowing for the possibility of switching back to the original seepage pit to give the new
trench a rest. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for
your review.
The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil
log, the native material between 4 feet and 18.5 feet is a silty sand with a measured perc rate of 4
minutes per inch. Using a slightly conservative soil application rate of 0.8 gpd/sq, ft. specified in the
wastewater ordinance for soils with pert rates between 6 and 15 minutes per inch, this 4 bedroom
residence requires a total absorption area of(4 x 150)/0.8 = 750 square feet. The proposed 68 foot long
trench design with an effective gravel depth of 6 feet has a total absorption area of 816 square feet.
The topography of the lot slopes down to the north and west at approximately 2%. The exact
configUration of the existing seepage pit is unknown, but has been plotted as accurately as possible
based on the original inspection report. No evidence of septic contamination was observed while test
hole #1 was being excavated, leading us to the belief that the north-south leg of the trench can be
constructed between the existing seepage pit and the shed shown on the site plan. Of course, if bleed-
through is encountered during construction we will field-modify the configuration accordingly.
The proposed project will have no significant impact on present or future water supply and
wastewater disposal systems serving adjacent properties, nor will it have any significant impact on '
reserved space-surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have
any questions on this submittal.
Sincerely,
Ted Moore, P.E.
LOT 1lA
BLOCK 3
SEPTIC ,,
SYSTEM
CONSTRUCT 68' LONG
SOIL ABSORPTION TRENCH
WITH 6' GVL. BELOW PIPE
,' T.H.
,' #2
28, #1
LOT 9
BLOCK 3
,, LOT 10
,' BLOCK 3
C
NEW
1250 GALLON
SEPTIC TANK
DBL.
SEPTIC
SYSTEM
EXISTING
4 BDRM HOUSE
B
INSTALL
VALVE
EXISTING
SEEPAGE P]T
CONFIG.)
WATER
KEY BO)
L10, B3, VALLI VUE #2
SEPTIC SYST. UPGRADE
SITE PLAN
FLATTOP TECHNICAL SERVICES 1 INCH = 30 FEET
14530 ECHO STREET DRAWN BY TFM
ANCHORAGE, ALASKA 99516 MAY, 1998
NOTE: THIS IS NOTASURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
SEPTIC
SYSTEM
LOT 9
BLOCK 3
LOT 11A
BLOCK 3
,' INSTALL NEW
,; SEPTIC TANK
RECONNECT LINE
TO SEEPAGE PIT
SEPTIC
SYSTEM
,' LOT 10
BLOCK 3
EXISTING
4 BDRM HOUSE
COLLAPSING
0 GAL. SEPTIC TANK
& 500 GAL. SEPTIC TANK
EXISTING
SEEPAGE PIT
WATER /
KEY BOX /
/
LI0, B3, VALLI VUE EST t/2
SEPTIC TANK REPL.
SITE PLAN
FLATTOP TECHNICAL SERVICES 1 INCH = 30 FEET
14530 ECHO STREET DRAWN BY TFM
ANCHORAOE, ALASKA 99516 APRIL, 1998
NOTE: THIS IS NOT A SURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
4" D-3034 FROM ~
DI ,VERTER'VALVE %
c.o. ~,L ~%:~
CONSTRUCT 60' LONG
SOIL ABSORPTION TRENCI
WITH 6' GVL BELOW PIPE
PLAN VIEW
SCALE: 1" = 20'
-810 PERF PIPE
ONITOR TUBE
VlOUND BACKFILL 12"
ORIGINAL GROUND
FABRIC
4" DIA, F-810 PERF DIST. PIPE
1/2" - 2 1/2" sEwER GRAVEL
OF EXCAVATION
SECTION"A-A"
SCALE:I"=5'
L10, B3, VALLI VUE ~2
SEPTIC SYSTEM UPGRADE
PLAN AND CROSS-SECTION
FLATTOP TECHNICAL SERVICES SCALE: AS SHOWN
14530 ECHO STREET DRAWN BY: TFM
ANCHORAGE, AK, 99516 MAY, I998
Flattop Technical Services
14530 Echo Street, Anchorage, AK 99516
Phone (907) 345-1355
Lot 10, Block 3, Valli Vue Estates//2
6462 Lone Tree Circle
Wastewater disposal system installation
Specifications
1.0 General:
1.1 The scope of the project consists of constructing a 68-foot long soil absorption trench with a total
of 6 feet of sewer gravel below the horizontal distribution pipe.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform to Municipal and State
requirements. All separation distances shall be in conformance with Municipal requirements, unless
specifically waived.
1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around
any buried utilities.
1.4 The contractor shall provide adequate cover material and rough grading over all system
components to ensure that proper drainage is achieved after settlement and that there are no residual
depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after
the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the
construction.
2.0 Septic Tank:
2.1 A new 1250-gallon septic tank was recently installed to serve this residence. A "Bull Run"
diverter valve shall be installed in the waste line downstream of the double cleanout allowing septic tank
effluent to be switched between the original seepage pit and the new soil absorption trench.
3.0 Soil absorption system:
3.1 The soil absorption system shall be constructed by excavating a 68-foot long trench to a
maximum depth of 12.5 feet below ground level in the vicinity of test hole #1. The configuration
shall be as shown on the site plan, unless bleed through from the original seepage pit is encountered.
If bleed-through is encountered, necessary field modifications shall be coordinated with the
inspecting engineer.
3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked
to allow proper infiltration.
3.3 A total of 6.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with
'the perforated distribution pipes laid level such that the pipe inverts are no less than 6.0 feet above the
bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing
the #200 sieve.
3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on
the design drawings. The portion of the monitor tube extending through the sewer gravel shall be
perforated.
3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A
minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less
than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the
gravel, in addition to the filter fabric.
3.6 The top surface of the cover material shall be raised a minimum of 12 inches higher than the
surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill
slopes shall be no steeper than 3:1.
3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have
the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and
seed to promote rapid revegetation of all areas disturbed by the construction.
4.0 Inspections:
4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1)
initial stakeout with the contractor to establish the location of the system and to discuss the plans,
specifications and construction procedures, (2) after the native material has been excavated to expose the
infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test
information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected
up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and
grading is complete.
4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
· TEST HOLE
LEGAL DESCRIPTION:
DATE PERFORMED: April 23, 1998
PERFORMED FOR: Richard Randall
DEPTH --
(feet) Pt.
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 10. Block 3. Valli Vue Estates. Unit #2
SM Reddish sandy loam
SM Gray gravelly sand
9 SM Gray silty sand
Dry, Fine, Soft
10- Lenses of SP
Lenses of ML
SLOPE
Depth to Groundwater Date
No Groundwater 4/23/98
Monitor tube dry 4/30/98
SITE PLAN
Date Reading Clock Net Time Percometer Net Drop
Time (minutes) Reading (inches)
4~23 12" presoak
Add water & star[ 3:11 23 1/2
#1 3:16 5 21 7/8 1 5/8
Add water 3:16:30 23 1/2
#2 3:21:30 5 21 7/8 1 5/8
Add water 3:22 23 5/8
#3 3:27 5 22 1 5/8
PERCOLATION RATE 4
TEST RUN BETWEEN 7.75
COMMENTS: Recommend basing design on $ - 15 rain/inch
(minutes/inch) PERC HOLE DIAMETER
FTAND 8.25 FT
WAT
PERFORMED BY FLATTOP TECHNICAL SERVICES. I ~",-~ ~ CERTIFYTHATTHiSTESTWAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: .5'"/// /c~ ~
TEST HOLE
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
DEPTH
(feet) --
1-
2
3-
4-
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 10 Bock 3. Valli Vue Estates: Unit #2
April 23:1998
Richard Randall
Pt
SM Reddish sandy loam
SM/ML Gray silty sand
some cobbies
Denser and tighter
than T.H. #1
SLOPE
Depth to Groundwater Date
No Groundwater 4/23/98
' SITE PLAN
~ ~iH' LOT 10
BLOCK
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
COMMENTS:
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETVVEEN FT AND FT
No monitor tube set or perc test conducted. Soils visually appeared to be less desirable than those in Test Hole #1.
WA
PERFORMED BY FLA~rOPTECHNICALSERVICE8. I ~.-~"~?'~"~-'~c CERTIFYTHATTHISTESTWASPERFORMEDIN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
:'4UNICIPALITY OF ANCHOI~XGE~
HeaJ~,~ and Environmental Proted~on
Fourt. h Floor West
825 L S'hreet
Anchorage, Alaska 99501
264-4720
................. ~N'~'EcTtON REPOR¥ ON-SITE SEWAGE DISPOSAL SYS'J'E/~
SEPTIC TANK:
TII_E DRAIN FIELD:
TOTAL LENGTH
DI'3"I/,NC E FROM \"/ELl ........ FOUNDATION ...... NEAREST LOT L NE .......... OF LINE
" of Lihes DIS[ANCE BETWEEN LINES ....... TRENClt WIDTtt____ IN, TOTAL ~[FFECTIVE
SEEPAGE PIT:
Log Crib
DIAMETER __.__ OR YVlDTH___, LENGTH .... DEPt'H
Rings
Crib Size: DI/\N,IE'IEtt ...... DEP¥11 DISTANCE FROMJ WELL
TOTAL EFFECTIVE
NEAP, EST LOT LINE ..... ABSORPTION AREA (WALL AREA)
;]1
,.ass: l)epth:
~]] Distance To: Lot Line
irlg: Sewer Line:
.pc Haterials: ~,\, _
ef Bedrooms: ~
FIF'PLICBNT .¢RCKS BFiC:~:H~]F ".-;V 8525 PLUTO
LOCFI]"ION LONE TREE HFIIN TREE
LEGAL L 10 B ~ VFIL. LI VUE
T'¢F'E OF SOiL HE,_,LRE, TIJN _,~r_,lE.t'l I_, F1
I'IFIXIMUH NUMBER OF BEDROOMS = 4
LOT SIZE
_-.4.4 ~,4-~J4
20000 L:;6!UFiRE FEET
· JIL RRTING ,:Sg! Ff, EE.- 0
THE REQIJZRED _,lEE L]F THE SOIL HE=uRFTIuN _-~TEti
E:,E:F"'T'H= 2':5 LEi'",IISTH= ~7-'l L~F~.H · F.~L_ E:"EF"-FH=:- 6
]'HE LENGTH DIMENSION IS ]'HE LENGTH (IN FEET) OF EFICH SIDE FOR R SEEPAGE PIT.
THE DEPTH OF' B TRENCH OR PIT IS THE [:,ISTRNCE BETWEEN THE SURFRCE OF THE
GF.'.OUND FIND THE BOTTOM OF I'HE EXCAVBTION ,:IN FEET>.
THE GRFI'v'EL DEPTH IS I'HE MINIHUH DEPTH OF GF.:RVEL BETWEEN THE OUTFFtLL PIPE
RN[:, THE BOTTOFt OF THE EXCAVRI'ION (IN FEEl').
' FI PFIC'KFIGE PLANT MRS' BE INSTFILLED FIT THE PERMITTEE'"S OPTION SUBJECT TO TNE
FOLLOWING CONDITIONS:
i. EITNER FI CLASS I OF.: Il NSF RPPROVED PLANT f'lFlY BE INSTALLED.
2. FI CONTINUOUS MFIINTENFtNCE AGREEMENT IS REQUIRE[:,. IF FI MFlINTENRNCE
I=tGREEMENT IS NOT KEPT CURRENT '¢OU MFt'z' BE REQUIRED TO ENLARGE THE SOIL
ABSORPTION S'¢STEM RNDZOR 't'OU MR'¢ BE SUBJECT 'TO PROSECUTION.
,-~,- .... --. , '~N~-
BFICKFILLiNG OF RN'¢ :t:,TEII WITHOUT FINRL INSPECTION RND HFFRL,HL "FHZS
DEPRRTHENI' WILL 6E _,IJE, JEuT TO P~.u~E_.JTILN.
i"tlNIidUM DISTBNCE BETWEEN R WELL. AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM tS
±00 FEET FOR R PRIVATE WELL OR 200 FEET FOR B PUBLIC WELL.
OTHER REQUIREMENTS MRb' BPPL¥. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
RVFIILRBLE TO INSURE PROPER INSTALLATION.
F"EF.'i"'I ][ 'f E:--::F' ]t: F-:E$ [)EL. Elf iBEF-: 2;1.. "' '=~'~--'-
I CERTIF~F THRT
i: I Fli"l FRMILiRR WITH THE REQUIREMENTS FOR ON-SITE -'~EHER_, RND ~,,JELL.~, FIS _,ET
F_IRTH E,'~ THE MUNICIPRLIT'T' OF RNZ:HORRGE.
2: I WILL INSTRLL THE :.~TEH IN RCCORDRNCE WITH THE CODES.
]:: I UNDERSTRND THRT THE ON-SITE _,EH~R _,N_,TEI1 I"lRN' REQUIRE ENLRRGEMENI' IF THE
7'.E~[:,ELED TO INCLUDE MORE THRN 4 BEE:,ROOMS.
.... ...............
GRE[-' R ANCHORAGE AREA BOF"JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME '~'/~//2/~'7~. ~7~-~7~'~'/~,~7E~ MAILING ADDRESS '~ 2d 3.~.5-/ ~'.1'~)/ PHONE
SEPTIC TANK:
DISTANCE .~'~ &/~_ NUMBER OF
FROM WELL MANUFACTURER MATERIAL / ,~,~lr~ COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH .LIQUID CAPA i~Y / ~
~ GALLONS.~
SEEPAGE PIT:
/
NUMBER OF PITS DIAMETER OR WIDTH I~ !. LENGTH ~,! DEPTH I~] /
LINING MATERIALg~7~-~ /p"
~'/CR~3SIZE: DIAMETER__DEPTH ~ ! DISTANCE FROM: WELL
BUILDING FOUNDATION ~ NEAREST LOT LINE~
TOTAL
EFFECTIVE
__.. ABSORPTION AREA (WALL AREA)
SQ. FT.
ADDITIONAL ABSORPTION
WELL: L~-/~ ~/
TYPe CONSTRUCTION
BUILDING NEAREST
FOUNDATION __ LOT LINE
CESSPOOL OTHER SOURCES
APPROVED ~ DISAPPROVED
NEAREST
SEWER LINE
REMARKS
__DEPTH
SEPTIC
TANK
DISTANCE FROM:
SEEPAGE
SYSTEM
DISTANCES:
INSTALLED BY:
PiPe MATERIAl:
LOT SLOPE:
REMARKS:
Form NO. EQ-031
f
DIAGRAM OF SYSTEM
DATE ¢-/,.~-~z/ APPROVE[;~
G.A.A.B.
GREATEr ANCHORAge AREA BOROUGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS ~
COMPLETION DATE ANTICIPATED
TO BE INSTALLED BY
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY Will BE SUBJECT TO PROSECUTION.
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK
DRAIN fIELD
SEPTIC TANK, , SEEPAGE PIT
TO RIVER, LAKE, STREAM.
, SEEPAGE Pit ~01'
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT ~[
, DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 iNCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTight REMOVABLE CAPS.
f
DIAGRAM OF ~YSTE:M
I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-EB AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. //~. ~ /~~
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" Street
ANCHORAGE, ALASKA 99503
Case #
Performed For T~ ~k~T-~.~Rl~ Dated Performed
Legal Description: Lot lO Block 3 Subdivision ¥~1~'~ Ykl~
This Form Reports Soils Log~ PerColation Test
- Soil Test 14ust Be Logged To 4' Below Proposed Seepage System -
Depth
Feet Soil Characteristics
3~
4--
7--
8--
9--
11--
12--
14--
Was Ground Water Encountered?
/ --: >-7- ~h>Z,~~-
If Yes, At What Depth?
Reading
Date
Gross Time Net Time Depth to N20
Net DropI
Percolation Rate MinuLe Proposed Instal-lat~on: Seepage Pit
Depth of Inlet Depth to Bottom
BY:
Date:
Drai p, Field
ot~-Pit Or Trench
Municipality of Anchorage
• �" Development Services Department _
Building Safety Division s ,
On-Site Water &Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us t7d
(907) 343-7904 �� ✓
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING nnhh
Parcell.D. 015-341-23 HAA# �U Q05
1. GENERAL INFORMATION Expiration Date: 7-9-0,67 —z5 -0S
Complete legal description VALLI
VUE ESTATES SUBDIVISION #2:
WHITE Day phone
LOT 10, BLOCK
3
❑
Public Water System
3201 C
STREET, SUITE 200 *
Location (site address or directions)
6462 LONE TREE CIRCLE
*
ANCHORAGE. AK
* 99507
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
THOMAS & JANE FRENCH Day phone 271-1322
Day phone
TERESA BELL
W/ PRUDENTIAL JACK
WHITE Day phone
563-5500
Community Class C Well
❑
Public Water System
3201 C
STREET, SUITE 200 *
ANCHORAGE, AK *
99503
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
❑
Individual Water Storage
❑
Community Class C Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE (�
l'� Approved for r bedrooms.
Disapproved.
Conditional approval for
Phone 337-6179
Date C, t2.1 04
bedrooms, with the filowing stipulations:
J.
WATER AND
WASTEWATER ;
:_ PROGRAM
N.
tachments:HAA Checklist l✓ Manitenance Agreements JJJJ'J/NWT
1�7TT—I
Septic System Advisory Supplemental Engineer's Reort
Well Flow Advisory Other
By; Original Certificate Date: / ' 7S — O /'
(Rev. 12/01)
I
hereby
certify that I hwa wrveyed the following described property, Lot /0 Block -? r'�'C Or A����`
VAL L / Vi/f FSi ,41"e"5 R � 1 Anchorage recording Precinct, Alaska, end that 9'PA, ••�.eseeep egts �,
the improwmentt situated thereon are within the property lines and do not owrlaD or oto .e' �e�
encroach on the r property /* z *
property lying adjacent thereto, that no irtlprowmsnn dh 7u
lying adjacent thereto encroach on the premises In questbn and that there areno roadways, 0 •• 49eIH aaee�ea�.�••r
transmission lines or other visible easements on said property except as Indicated hereon.
_ ,.}- �f�pp_ _
�' % ;• fronts Xildonaa
29 ✓u NF /; 1#s,,-%* No. 13064
Anchorage, Alaska % t .yf •rM•• •a,l
RECL"FT'lr�'lEp 4Q.`1UNr 20. 4iI` �4%L- ��
N L y
(/
3CAL E l •30
pN
1
V)
EASEfT,mn OF RECORD, OTHER THAN
THOS' SHO\NN
ff�
Pi.A', ARE NOT
SHOWN HEREGW.
7o\ Set This
Date Book No.
Page No
{'
/300.
As Built"
I
hereby
certify that I hwa wrveyed the following described property, Lot /0 Block -? r'�'C Or A����`
VAL L / Vi/f FSi ,41"e"5 R � 1 Anchorage recording Precinct, Alaska, end that 9'PA, ••�.eseeep egts �,
the improwmentt situated thereon are within the property lines and do not owrlaD or oto .e' �e�
encroach on the r property /* z *
property lying adjacent thereto, that no irtlprowmsnn dh 7u
lying adjacent thereto encroach on the premises In questbn and that there areno roadways, 0 •• 49eIH aaee�ea�.�••r
transmission lines or other visible easements on said property except as Indicated hereon.
_ ,.}- �f�pp_ _
�' % ;• fronts Xildonaa
29 ✓u NF /; 1#s,,-%* No. 13064
Anchorage, Alaska % t .yf •rM•• •a,l
RECL"FT'lr�'lEp 4Q.`1UNr 20. 4iI` �4%L- ��
(/
3CAL E l •30
pN
EASEfT,mn OF RECORD, OTHER THAN
THOS' SHO\NN
ON THE REConD"
Pi.A', ARE NOT
SHOWN HEREGW.
7o\ Set This
Date Book No.
Page No
I
hereby
certify that I hwa wrveyed the following described property, Lot /0 Block -? r'�'C Or A����`
VAL L / Vi/f FSi ,41"e"5 R � 1 Anchorage recording Precinct, Alaska, end that 9'PA, ••�.eseeep egts �,
the improwmentt situated thereon are within the property lines and do not owrlaD or oto .e' �e�
encroach on the r property /* z *
property lying adjacent thereto, that no irtlprowmsnn dh 7u
lying adjacent thereto encroach on the premises In questbn and that there areno roadways, 0 •• 49eIH aaee�ea�.�••r
transmission lines or other visible easements on said property except as Indicated hereon.
_ ,.}- �f�pp_ _
�' % ;• fronts Xildonaa
29 ✓u NF /; 1#s,,-%* No. 13064
Anchorage, Alaska % t .yf •rM•• •a,l
RECL"FT'lr�'lEp 4Q.`1UNr 20. 4iI` �4%L- ��
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P:O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
,~PPROVAL FOR A S NGLE FAMILY DWELLING
~1.~'- - .?~/ - 2--Z HAA# ~"~ ~<::~
GENERAL INFORMATION
Corn plete legal description
Location (site address or directions) :¢"¥ ~" ~-
Property owner
Mailing address
Lending agency
Mailing address
Agent /v'. ~-.
?.'o..,5' o ~ ~...7 o
Day phone
Day phone
Day phone
v
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYpE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev. 1/91) Front MOA#21
Engineer's signature
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I ver!fy that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structu re indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm '[=1¢' /-~/' 7-~4n,'¢~/ ._q~r~',~. Phone
Address /~/~'_TdJ ,~4~ _~'/:., ~c~or~, ~
~~ ~ ~ Date
DHHS sIGNATURE
/,'"/ Approved for
/c'¢ U ./~ bedrodms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department (~f 'Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
RECEIVED
Municipality of Anchorage $£P 14
DEPARTMENT OF HEALTH & HUMAN SERVICES
......... ~/,UNIClPALI [1' OJ: ANCH~
~.nvlronmenTal ~ervlces UlVlSlOn I
825 L Street, Room 502 * Anchorage, Alaska 99501 · (907) 343-4744
Legal Description: .L.. Iq, G/~ ~.,
A. WELL DATA
Well type ' (Z/~.~.r "A"
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Health Authority Approval Checklist
~,~//,. L-'~ ,~.~/- -F~-&. Parcel I.D.:. 0~- - ~'¥/- ~'-~
IfA, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to
FROM WELL LOG
g.p.m.
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
· Coliform
Date of sample:
B, SEPTIC/HOLDING TANK DATA
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
Nitrate
Collected by:
Date installed ,-//1¢ /~,~ Tanksize I'z.5"O,.~,~I Number of Compartments
Foundation cleanout (Y/N) T' Depression (Y/N)
Date of Pumping ~' / z,s'-/~ Pumper
C. ABSORPTION FIELD DATA
Date installed ~-/?-.7 / ?~
Length 7 ~-' Width
Effective absorption area ~'~'¥ Monitoring Tube present (Y/N)
Date of adequacy test /V.,,4. ~_~. ~/,,- o~)Results (Pass/Fail)
~ tO 6~ob-
Other bacteria
~ Cleanouts (Y/N)__
High water alarm (Y/N) ~'.4,
Soil rating (g.p.d./ff2 or ~/bdrrn) ~ System type
Gravel thickness below pipe ~, ~ Total depth
Depression over field (Y/N) __
For ~
bedrooms
Fluid depth in absorption field before test (in.);
Fluid depth (ins) Minutes later:.
Peroxide treatment (past 12 months) (Y/N)
72-026 (Rev. 3/96)*
/V
g.p.m.
Immediately after gal. water added (in.):
Absorption rate = ~ 5~o~ g.p.d.
If yes, give date ,v.,4,
D. LIFT STATION ~/.
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at*
*Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
/V. ,~. ~'-~ ~.
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation / 4)' Property line ,5"5' ' Absorption field
Water main/service line ~ ID' Surface water/drainage '~' ~,oo '
SEPARATION DISTANCE FROMABBORPTION FIELD ON LOTTO:
Property line £' Building foundation
Surface water '~
Cur/ain drain t,/,-> ~ ~ _c~ ~'~
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal
in conformance with MOA HAA guidelines in effect on this date.
Signature ~-,~-~--~--- ~ ~
Engineer's Name '7-/) ~,~ J,~r~ ~..
Date ~ //'/
"Pump off" level at*
Wells on adjacent lots
Water main/service tine '>
Driveway, parking/vehicle storage area ~ ,~-~'
Wells on adjacent lots
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
OF ON-SrTE SEWER AND WATER FACILITY
264-4744
Application Date
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAl-)
-~,=- ,' . ~ /" \ i"-_-' "
Location (address ~) ' ~{~ ~
(b) PropedyOwner ~~ Telapk~ae:~ome ~-~ Business
Mailing Address
(c) Lending Institution
Mailing Address
Telephone
(d) Real Estate Company and Agent
Address
Telephone
(e) Mail the HAA to the followin~ address: or: Check here ~, if hold for pick up.
List contact person and day phone number below.
TYPE OF RESIDENCE
Single-Family~x
Number of Bedrooms
WATER SUPPLY
Individual Well [] Community~ Public []
Note: If corn munity well system,/''''' '~must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite [] Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation
attesting to the legality and atatus.
Page 1 of 2 72-025 (Rev 8/861 Front
ENGINEERING FIRM PROVIDI~,~_jiNSPECTIONS, TESTS, FILE SEARCH, DL..~[ AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this insp~. _ /~
Name of Firm ~/. ,:~~ Telephone ~'~ ~- '~ ~/~
Address /~~' "~ I,~ / ~"~
Date
Engineer's Seal
DHHS APPROVAL
Approved ,o, -/~-~" ~"'~ bedrooms by ~¢¢.~,., /42,
Approved /'~ Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
certificates based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in
order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data
before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional
engineer's work.
Page 2 of 2 72-025 IRev 8/861 Back
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
· N 2 '3 1987
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description: b~¢"~
WELL [ EIVED
Well Classification (_'~/-.A ¢' '
If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N)
Total Depth Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments
Date Completed Yield
Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
B. SEPTIC/HOLDING TANK DATA
Date Installed ','/?V['] '~¢7 Size lofJ~ ./-~o-¢-¢ No. of Compartments ~ ~/' ~ '~
t
Standpipes (Y/N) .~ Air-tight Caps (Y/N) ~¢' Foundation Cleanout (Y/N)
Depression over Tank (Y/N) ~! Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) he.//-~N ; for
Holding Tank High-Water Alarm (Y/N) jx¢/'~,¢~. Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
> ..2.0-,0
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72 026( 11/84}
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~'
Width of Field J
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
Type of System Design
Length of Field
~'] Depth of Field
Gravel Bed Thickness
¢¢~ ~ r¢~ Standpipes Present (Y/N)
/"¢ Date of Last Adequacy Test
......
To Water-Supply Well
To Building Foundation
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots ~
To Cutbank (if present)
~,-~ t')
Comments
D. LIFT STATION ]'V" ~';~ N~,
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request
I certify that I .ha_~ve checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed "~ ,, ~/f.~,&~d?z~'~'~-~--'''~/ Date
Company MOA No.
Receipt No. /O
Date of Payment
Amounf:$
Page 2 of 2
72-026 {11/84)
Engineer's Seal
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA g9501
BILL SHEFFIELD, GOVERNOR
Telephone: (907)
Address:
274-2533
DATE: January 28, 1987
PWS I.D.# 210605
To Whom it May Concern:
According to records on file in this office the VAnLIE rUE
Water System is in compliance with the State Drinking
Water Regulations
Sincerely,
~Supervisor
CONSULTING ENGINEER ~ ~ ~ ANCHORAGE ALASKA 99501
]~ELEPHONE: (907) 279-3916
SEPTIC SYSTEM ADEQUACY
TEST
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WELL:
SEPTIC SYSTEM:
LOT 10, BLOCK 3, VALLI VUE ESTATE
6426 LONETREE CIRCLE ~k~.'
FRANK GARRETT ~t:' 49~
~ ...... ~ ..... ~.~..t~.~
COMMUNITY CLASS A SYSTEM ~J ~)'. .'-~
FROM MUNICIPAL RECORDS: ~',<'~',~-~73~,
TANK: STACK STEEL TWO COMP. 10~'~-
GREER STEEL, TWO COMP. 500 GAL.
ABSORPTION SYSTEM: CONCRETE CRIB
ABSORPTION AREA: 828 SQ. FT.
SOIL RATING: 200
INSTALLATION DATE: SEPT. 1974
DATE OF-PUMPING: JANUARY 27, 1987. ROTO ROOTER
DATE OF TEST: JANUARY 27, 1987.
TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANKS WERE
FOUND WITH FIVE FEET OF COVER. 1000 GAL TANK HAD 49 INCHES OF
LIQUID, 500 GAL TANK 39. CONCRETE CRIB WAS FOUND 15 FEET DEEP
AND WITH 73 INCHES OF LIQUID. WATER WAS ADDED TO THE CRIB AT A
CONSTANT RATE OF TEN GALLONS PER MINUTE WHILE THE LIQUID LEVELS
IN TANKS AND CRIB WERE MONITORED. AFTER ADDING 150 GALLONS THE
LEVEL IN THE 500 GAL. TANK STARTED TO RISE. WATER FLOW WAS
STOPPED AND INFILTRATION RATE MONITORED FOR 2.5 HOURS. DURING
THIS PERIOD 72 GALLONS OF WATER WAS ABSORBED. EXTENDED TO A 24
HOUR PERIOD THE INFILTRATION RATE IS 690 GALLONS PER DAY.
TEST RESULT:
THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served by the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimase of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
/v~UNICIPALI J Y Oh
MUNICIPALITY OF ANCHORAGE DEPT, OF V;'~J.T:~ &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC~iRONR",ENTAL i:;:'-I~CTION
825 L Street - Anchorage, Alaska 99501
WAY 1 0 g79
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 2~4-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed, Please allow ~eN (10)days for processing. !~
· _ 7 .5y
PROPERTY RESIDENT (If different from above)
2. BUYEI~I t fl / /
MAI LING ADD R ESS /
PHONE
4. REAL'TOR/~.G EN'r ./ /
c. 5-/.
STREE 'LC~CATI O N / /
6. TYPE OF RESIDENCE NUMSER OF BEDROOMS
E] One ~Four
E~-SI NG LE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
[] Other
7. WATER SUPPLY [] INDIVIDUAL*
~ COMMUNITY
[] PUBLIC UTILITY
*ATTACH WELL LOG. A well Icg is reqdired for all wells drilled
since June I975. For Wells drilled prior to that date, give well
depth (attach Icg if available.) /,~
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE~
[] PUBLIC UTILITY
**If individual/on-site, give installation date /¥~' .
If system is over two (2) years old an adequacy/fest~is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR iNSPECTOR iNSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LO(:; RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] I NDIVI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY ~ -1:~--'7 c/~
Connection Verified INSTALLER
Size: JO~ ~ ~o If Tank is homemade SOILS RATING
give dimensions: ~. ~0
T~PE OE TAN~ MANUEACTURER, %V~< e ~ ~ ~ ~/~?
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS ~W.--~ ~
[~-~'APPROVED FOR ,~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY ('rltle) ,,"/
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
'flUNIC~PALtTY OF ANCHOR~AG[ ,
street, ~chorage, AlaSka 99501 '[.
279-2511, ext: 224, 225
Date Re ceived~ ~arch 25
let Inspe_ction: Time J,'~ PPA
Date ~.-] ~-77_, ~L.
Inspector
2nd
TnsDection:
Date
Inspector
REQUEST FOR APPROVAL O~' INDIVIDUAL SEWER AND WATER FACILITIES
t. Lending insti-hution Requ~su: National Bank of Alaska
Mailing Address: Post Office Box 3-3859 99509 Phone: 279-2506
2. Property Owner: Donald/Jean Wyman
Mailing Address; 6462 Lone Tree Circle 99507
Phone: 344-8539
3. Legal Description: Lot 10 Block 3 Valli Vue Estates Subdivision #2
Single Family Residence: (x) Number of Bedrooms: 4
hu]?.lp~e Family Residence: ( ) Number of Bedrooms: __
5. Well Data: Type Community
Cons ~ructlon
Depth Well Log Filed
Bacterial Analysis
Sewage Disposal
Permit ~
System: On-site szstem (x) Public Utility ( )
Installed "1974 Iastaller
Septic Tank Size
Absorption Area ~
Manufacturer
Soils Rate ~ ~ Materi
7. Dzstances: Well to Septic Tank
to Absorption Area
to Sewer Lines Nearest Lot Line
Absorption Area to Nearest Lot Line
i!~ · ,~: ,De~artment'~0f~'Heal~h and'Environmental, ProtectiOn
· Reque·st for Approval of Individual Sewer and Water ~acilities
Legal Description: Lot 10 Block 3 Valli Vue Estates Subdivision #2
Letter Attached: ( )
GREAIER ANCHORAGE ARb/, BO ...... IGH
Department of Envi rol!l~tentat Qual i ty ANCPIO~AGE
3330 "C" St., Anchoi'age, :Alaska 99503
REQUEST FOR APPROVAL OF MAR 5 igll ·
INDIVIDUAL SEWER &WATER FACILITIES RECEIVED
1. Type of inspection: CMRO VA
2. Property Owner:
FIiA
CONV --XX '-'
Mailing Address: 6~2 Lo~e~-T-r-ee_ Ci-r-c~
Anchorages AK 99501
Nar~:- , Buyer. M~. .... ,N~F~ ......... ' -
~,~,,~,d G~,,
D__&_ Phone
Mailing Address: 4.~ BusingS. ='~ .... ~~-~
Name of Le'ndi ng !n~~ :Ak 99503 _~_~-B~f A~k~
M a i 1 i n g A d d r e s s: p~~A~r~---~h o Ef~ 2506
99501
Name of Realtor or Agent:Ba~a g. L.a~nE;.AR[A,-Inc: RE~S
/ Phone q~ ~
Mailing Address: E~tc ~m~-o, . Nort~ .... " ......
Lights, Anchorage, AK 99504
Day Phon~ ~344
Legal Descri pti on: _ Loi;.._l_O~_]t]ock~t VzJ_lJ_~.NLuP~-~2
Location: 6462 Lon_e Trpe Circle_
Anchoraqe~/~K___995___0~
Type of Facility to be inspected: s~j_le_~a~ly.h~me~
Nater Supply Community Well for Valli-Vue
Type of Supply: Public utility _XX ..~ Individual
If Individual, number of dwellings presently served
Public Utility
If Individual, depth of well
Sewage Disposal'System
Type .of S~stem:
If Individual, date of installation
Individual (on-site)
_XX¸